Page 294 - Critical Care Nursing Demystified

Chapter 6 CARE OF THE TRAUMATIZED PATIENT 279

TABLE 6–5 Types of Le Fort Fractures
I Horizontal fractures in which the entire maxillary arch moves separately
from the upper facial skeleton
II An extension of Le Fort I that includes the orbit, ethmoid, and nasal bones
CSF rhinorrhea with this and Le Fort III
Extends nasal bridge through the frontal processes of the maxilla, through
the lacrimal bones and inferior orbital bones; travels under the zygoma
III Serious craniofacial disruption in which cerebrospinal fluid frequently leaks
May follow impact to nasal bridge and extend through the nasolacrimal groove
and ethmoid bone; the fracture continues through the floor of the orbit
This type of fracture predisposes the patient to a CSF leak more than the
other types of fractures

Change in the level of consciousness if head injury or hypoxemia.
Anxiety.
Fractures of the maxilla are diagnosed according to Le Fort’s classification of
three broad categories that depend on the level of the fracture (see Table 6–5
and Figure 6–1). Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.

Le Fort I =
Le Fort II =
Le Fort III =

FIGURE 6–1 • Le Fort fractures.